The surgical treatment of tuberculous empyema

Summary

The incidence of tuberculous empyema can be reduced to small proportions by the early abandoning of contraselective artificial pneumothoraces, or by their conversion into selective ones by early cauterisation of the adhesions.

A small number of empyemata can be treated conservatively by high negative aspirations.

The majority of cases need thoracoplasty, which should be carried out early when active pulmonary lesions exist, and late when the pui-monary disease is quiescent and there is a hope that the apex can be made to expand.

Residual cavities are best treated by the Roberts flap operation.